From Social Distancing to Social Connections: Insights From the Delivery of a Clinician-Caregiver Co-mediated Telehealth-Based Intervention in Young Children With Autism Spectrum Disorder

Srinivasan, Sudha; Su, Wan-Chun; Cleffi, Corina; Bhat, Anjana

doi:10.3389/fpsyt.2021.700247

Cited by 20 publications

(27 citation statements)

References 39 publications

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“…Parents of children with ASD with greater ASD severity as seen by greater functional delays and repetitive behavior severity, and poor understanding about COVID‐19, families with younger children, low income were reporting the greater negative health impact on themselves and concerns about their families. It has been well‐established that caregiving stresses are much greater in parents of children with ASD with greater repetitive behaviors, language delays, and functional dependence and need more family supports (Srinivasan et al, 2021 ; Abbeduto et al, 2004 , Bromley et al, 2004 ; Brown et al, 2010 ). There are a few reports on how family supports such as respite care were not operational during the initial months of the pandemic (Chen et al, 2020 ; Spinelli et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…et al, 2020 ; Tenforde et al, 2020 ; Tomlinson et al, 2018 ; Tohidast et al, 2020 ). This author has modified an ongoing movement intervention clinical trial involving face‐to‐face interventions to a hybrid format wherein families are able to choose between in‐person vs. online/telehealth visits to complete testing and interventions as outlined in recent publications (Su et al, 2021 ; Bhat et al, 2021 ; Srinivasan et al, 2021 ). Allowing families to choose their preferred mode of clinical trial delivery has made it feasible to conduct the study in spite of hesitancy among families to participate in nonessential clinical interactions such as participating in a research study during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…Together, these challenges may have further affected children's and parent's emotional and mental health outcomes (Bellomo et al, 2020 ; Chen et al, 2020 ; Kalb et al, 2021 ; Nonweiler et al, 2020 ; Spinelli et al, 2020 ). As clinicians, educators, and researchers started rethinking therapeutic service, learning, and research delivery models including protocols in this author's lab (Bhat et al, 2021 ; Srinivasan, Su, et al, 2021 ; Su et al, 2021 ) many have chosen a hybrid delivery model – a combination of face to face interactions with precautions or a remote/virtual mode of care/education/research delivery. However, remote/virtual models of care do not work for all subgroups of children and more systematic studies will be needed to examine the perceived benefits of adding the option of virtual services.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the SPARK study COVID‐19 parent survey: Early impact of the pandemic on access to services, child/parent mental health, and benefits of online services

Bhat

2021

Autism Research

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Children with ASD receive a multitude of educational, medical, and therapeutic services. At the onset of the COVID-19 pandemic, all of these services came to a complete halt following strict lockdowns. Many services have resumed in a hybrid format using face to face and virtual modes of delivery. This study describes findings from the COVID-19 impact survey administered at the onset of the pandemic in a subgroup of families from the SPARK cohort (N = 6393), one of the largest ASD cohorts in the US. The differential early impact of COVID-19 on various subgroups of children with ASD and their families was examined. Caregivers of children and adolescents with ASD between 19 months and 18 years completed an online survey inquiring about the impact of COVID-19 pandemic on access to services, parent concerns about the same, impact on child's ASD-related behaviors, child, and parent mental health, and the benefits/potential benefits of online/ future online services. Analysis revealed that certain demographic (age, income/ SES) and child-related factors (repetitive behaviors, language, functional, cognitive, and motor impairments, and child's understanding), as well as parent's past mental health were associated with/predicted greater service disruptions, greater ASD-related behaviors, and greater negative impact on parent mental health. In conclusion, younger children, children from low-income families, and children with greater impairment severity (more severe repetitive behaviors, language, cognitive, function, language, and motor impairments) were more negatively impacted by the pandemic through service disruptions, increased ASD-related behaviors, parent health/family impact, and found online interactions to be less beneficial. Lay SummaryThe SPARK study impact survey shows that at the onset of the COVID-19 pandemic, parents reported significant service disruptions, negative impact on their child's ASD-related behaviors as well as their own mental health; which was greater in families with younger children, children with greater ASD severity, and children from low-income families. Majority of families did not report significant benefits of online services whereas some families did. Low-income families were hopeful about receiving benefits through future online services. Overall, these findings have important implications for future clinical care delivery and healthcare policies to ensure that healthcare services are not interrupted during a potential resurgence of COVID-19 or other pandemics. A combination of inperson and online healthcare and family support services must be implemented to prevent negative health impacts in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of the SPARK study COVID‐19 parent survey: Early impact of the pandemic on access to services, child/parent mental health, and benefits of online services

Bhat

2021

Autism Research

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“…While many randomized controlled trials came to a halt, we chose to reinvent our study by shifting to a home-based, telehealth format using Zoom videoconferencing (Figure 1). [16][17][18] Given that families were concerned about lack of optimal learning experiences for their children, 1 it was crucial for our research team to create materials and strategies that would best support children in our study. Similarly, some families had financial difficulties during the pandemic.…”

Section: Reinventing Our Research Approach During Covid-19mentioning

confidence: 99%

Using Telehealth to Conduct Family-Centered, Movement Intervention Research in Children With Autism Spectrum Disorder During the COVID-19 Pandemic

Cleffi

Srinivasan

et al. 2022

Pediatric Physical Therapy

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Purpose: After the COVID-19 pandemic, several randomized controlled trials came to a halt; however, we chose to reinvent our study and shifted to a home-based, telehealth intervention delivery format to support children with autism spectrum disorder and their families. Children with autism spectrum disorder have social communication impairments as well as perceptuomotor and cognitive comorbidities. Continued access to care is crucial for their long-term development. Methods: We created a general movement intervention to target strength, endurance, executive functioning, and social skills through goal-directed games and activities delivered using a telehealth intervention model. Findings: Our family-centered approach allowed for collaboration between trainers and caregivers and made it easy for families to replicate training activities at home. Conclusions: While more studies comparing telehealth and face-to-face interventions are needed, we encourage researchers and clinicians to consider family-centered telehealth as a valid and feasible intervention delivery method, to increase the likelihood of carryover of skills into the daily lives of children and ultimately enhance their long-term development.

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“…Lastly, after the onset of the COVID-19 pandemic, there has been a rise in use of telehealth as an alternative intervention delivery method. It will be important to understand the differences in behavioral and neural effects of physical activity/movement interventions delivered through virtual vs. traditional, face-to-face approaches (144)(145)(146)(147). Further research is needed to understand how different types and delivery methods of physical activity/movement interventions might lead to differential neural effects on social communication and cognitive performance.…”

Section: Implications and Recommendations For Clinical Practicementioning

confidence: 99%

Neural Effects of Physical Activity and Movement Interventions in Individuals With Developmental Disabilities–A Systematic Review

Amonkar

Cleffi

et al. 2022

Front. Psychiatry

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Individuals with developmental disabilities present with perceptuo-motor, social communication, and cognitive impairments that often relate to underlying atypical brain structure and functioning. Physical activity/movement interventions improve behavioral performance of individuals with and without developmental disabilities. Majority of the evidence on potential neural mechanisms explaining the impact of physical activity/movement interventions is based on studies in individuals with typical development; there is a dearth of systematic reviews synthesizing the neural effects of physical activity/movement interventions in individuals with developmental disabilities. In this systematic review, we have gathered evidence on the neural effects of physical activity/movement interventions from 32 papers reporting substantial neural effects and behavioral improvements in individuals with developmental disabilities. Chronic intervention effects (multiple sessions) were greater than acute intervention effects (single session). Specifically, using electroencephalogram, functional magnetic resonance imaging, diffusion tensor imaging, and functional near-infrared spectroscopy, studies found physical activity/movement intervention-related changes in neural activity, indicating normalization of cortical arousal in individuals with attention-deficit /hyperactivity disorder (ADHD), increased social brain connectivity in individuals with autism spectrum disorder (ASD), and more efficient executive functioning processes in individuals with a wide range of other developmental disabilities. Despite promising results, more research is clearly needed in this area with larger sample sizes, using standardized neuroimaging tools/variables, and across multiple diagnoses to further explore the neural mechanisms underlying physical activity/movement interventions and to replicate findings from the present review.

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From Social Distancing to Social Connections: Insights From the Delivery of a Clinician-Caregiver Co-mediated Telehealth-Based Intervention in Young Children With Autism Spectrum Disorder

Cited by 20 publications

References 39 publications

Analysis of the SPARK study COVID‐19 parent survey: Early impact of the pandemic on access to services, child/parent mental health, and benefits of online services

Analysis of the SPARK study COVID‐19 parent survey: Early impact of the pandemic on access to services, child/parent mental health, and benefits of online services

Using Telehealth to Conduct Family-Centered, Movement Intervention Research in Children With Autism Spectrum Disorder During the COVID-19 Pandemic

Neural Effects of Physical Activity and Movement Interventions in Individuals With Developmental Disabilities–A Systematic Review

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